New PET G HCPCS Codes- PENDING

September 7, 2004

New PET G HCPCS Codes- PENDING

You may have seen some new PET codes in recent Transmittals (278 & 255) and in publications such as Part B news, they include HCPCS codes G0336 PET Imaging, brain imaging for the differential diagnosis of Alzheimer's disease with aberrant features vs fronto-temporal dementia, G0330 PET Imaging, initial dx cervical CA and G0331 PET Imaging restaging ovarian CA. The Centers for Medicare and Medicaid Services (CMS) officials told the SNM, "these codes are place holder codes for the contractors", there currently are NO published coverage decisions on these PET G HCPCS codes and the indications. As per the CMS coverage process timelines, an official response may be available on or about September 15, 2004, for the Alzheimer indication. No information regarding the other two codes are available at this time.

The SNM would like to clarify that at present, pending an official coverage policy or instructions from CMS regarding these codes, providers should NOT implement or use them. We recommend that you take note of these new HCPCS codes, as CMS has, that they are place holders and be prepared to implement them when official policies are published.

The SNM has contacted CMS officials and are waiting a response and will alert you when we have official confirmation regarding these codes including official implementation dates and appropriate use when they become available.